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Jiao YC, Wang YX, Liu WZ, Xu JW, Zhao YY, Yan CZ, Liu FC. Advances in the differentiation of pluripotent stem cells into vascular cells. World J Stem Cells 2024; 16:137-150. [PMID: 38455095 PMCID: PMC10915963 DOI: 10.4252/wjsc.v16.i2.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/20/2023] [Accepted: 01/16/2024] [Indexed: 02/26/2024] Open
Abstract
Blood vessels constitute a closed pipe system distributed throughout the body, transporting blood from the heart to other organs and delivering metabolic waste products back to the lungs and kidneys. Changes in blood vessels are related to many disorders like stroke, myocardial infarction, aneurysm, and diabetes, which are important causes of death worldwide. Translational research for new approaches to disease modeling and effective treatment is needed due to the huge socio-economic burden on healthcare systems. Although mice or rats have been widely used, applying data from animal studies to human-specific vascular physiology and pathology is difficult. The rise of induced pluripotent stem cells (iPSCs) provides a reliable in vitro resource for disease modeling, regenerative medicine, and drug discovery because they carry all human genetic information and have the ability to directionally differentiate into any type of human cells. This review summarizes the latest progress from the establishment of iPSCs, the strategies for differentiating iPSCs into vascular cells, and the in vivo transplantation of these vascular derivatives. It also introduces the application of these technologies in disease modeling, drug screening, and regenerative medicine. Additionally, the application of high-tech tools, such as omics analysis and high-throughput sequencing, in this field is reviewed.
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Affiliation(s)
- Yi-Chang Jiao
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Ying-Xin Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Wen-Zhu Liu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Jing-Wen Xu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Yu-Ying Zhao
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao) of Shandong University, Qingdao 266103, Shandong Province, China
- Brain Science Research Institute, Shandong University, Jinan 250012, Shandong Province, China
| | - Fu-Chen Liu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
- Brain Science Research Institute, Shandong University, Jinan 250012, Shandong Province, China.
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Zhang H, Zhang B, Zhao B, Zhang TX, Zhao CP, Liu YM, Yan CZ, Zhao YY. [Clinical and genetic analysis of tyrosine hydroxylase deficiency of six cases]. Zhonghua Yi Xue Za Zhi 2023; 103:3140-3143. [PMID: 37840187 DOI: 10.3760/cma.j.cn112137-20230304-00323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
The clinical and molecular genetic data of 6 patients with genetically confirmed tyrosine hydroxylase deficiency(THD) diagnosed in Department of Neurology, Qilu Hospital of Shandong University from March 2017 to February 2022 were retrospectively collected and analyzed. The 6 patients were from 5 families. Among them, 5 patients had persistent or paroxysmal abnormal walking posture, 4 patients had dystonia of head and face, including spasm of perioral and oculopharyngeal muscles, hyperactivity, and binocular upvision, 4 patients showed obvious morning light and evening heavy phenomenon, 2 patients had postural tremor of limbs, 2 patients had psychomotor retardation from childhood, 1 patient only had limb and cervical muscle weakness, 1 patient had epileptic seizures. Of the 6 patients, only 1 was adult-onset, and the rest were child-onset. Four patients had good response to low-dose dopa preparation, 2 patients from the same family had poor response to dopamine treatment, requiring extremely low dose initiation and multi-frequency titration treatment. However, the long-term treatment effect was poor with obvious abnormalities. Gene testing of 5 families revealed 8 mutations in the TH gene, with c.698G>A (p.R233H) being the hot spot mutation site. The clinical manifestations of THD are complex. Besides paroxysmal or persistent dystonia, it can also be accompanied by eye movement crisis, muscle weakness, epilepsy, and delayed mental and motor development. Most patients respond well to low-dose dopamine preparations, but a small number of patients require titration treatment with extremely low-dose dopamine preparations, and the long-term effect is not satisfactory.
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Affiliation(s)
- H Zhang
- Department of Neurology,Qilu Hospital of Shandong University,Jinan 250012,China
| | - B Zhang
- Department of Neurology,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,China
| | - B Zhao
- Department of Neurology,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,China
| | - T X Zhang
- Department of Neurology,Qilu Hospital of Shandong University,Jinan 250012,China
| | - C P Zhao
- Department of Neurology,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,China
| | - Y M Liu
- Department of Neurology,Qilu Hospital of Shandong University,Jinan 250012,China
| | - C Z Yan
- Department of Neurology,Qilu Hospital of Shandong University,Jinan 250012,China
| | - Y Y Zhao
- Department of Neurology,Qilu Hospital of Shandong University,Jinan 250012,China
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Duan RN, Yang CL, Du T, Liu A, Wang AR, Sun WJ, Li X, Li JX, Yan CZ, Liu QJ. Correction: Smek1 deficiency exacerbates experimental autoimmune encephalomyelitis by activating proinflammatory microglia and suppressing the IDO1-AhR pathway. J Neuroinflammation 2023; 20:160. [PMID: 37407996 DOI: 10.1186/s12974-023-02834-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Affiliation(s)
- Ruo-Nan Duan
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Chun-Lin Yang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Tong Du
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Ai Liu
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - An-Ran Wang
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wen-Jie Sun
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xi Li
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Jiang-Xia Li
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Qi-Ji Liu
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No. 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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Zhao M, Su HZ, Zeng YH, Sun Y, Guo XX, Li YL, Wang C, Zhao ZY, Huang XJ, Lin KJ, Ye ZL, Lin BW, Hong S, Zheng J, Liu YB, Yao XP, Yang D, Lu YQ, Chen HZ, Zuo E, Yang G, Wang HT, Huang CW, Lin XH, Cen Z, Lai LL, Zhang YK, Li X, Lai T, Lin J, Zuo DD, Lin MT, Liou CW, Kong QX, Yan CZ, Xiong ZQ, Wang N, Luo W, Zhao CP, Cheng X, Chen WJ. Loss of function of CMPK2 causes mitochondria deficiency and brain calcification. Cell Discov 2022; 8:128. [DOI: 10.1038/s41421-022-00475-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
AbstractBrain calcification is a critical aging-associated pathology and can cause multifaceted neurological symptoms. Cerebral phosphate homeostasis dysregulation, blood-brain barrier defects, and immune dysregulation have been implicated as major pathological processes in familial brain calcification (FBC). Here, we analyzed two brain calcification families and identified calcification co-segregated biallelic variants in the CMPK2 gene that disrupt mitochondrial functions. Transcriptome analysis of peripheral blood mononuclear cells (PBMCs) isolated from these patients showed impaired mitochondria-associated metabolism pathways. In situ hybridization and single-cell RNA sequencing revealed robust Cmpk2 expression in neurons and vascular endothelial cells (vECs), two cell types with high energy expenditure in the brain. The neurons in Cmpk2-knockout (KO) mice have fewer mitochondrial DNA copies, down-regulated mitochondrial proteins, reduced ATP production, and elevated intracellular inorganic phosphate (Pi) level, recapitulating the mitochondrial dysfunction observed in the PBMCs isolated from the FBC patients. Morphologically, the cristae architecture of the Cmpk2-KO murine neurons was also impaired. Notably, calcification developed in a progressive manner in the homozygous Cmpk2-KO mice thalamus region as well as in the Cmpk2-knock-in mice bearing the patient mutation, thus phenocopying the calcification pathology observed in the patients. Together, our study identifies biallelic variants of CMPK2 as novel genetic factors for FBC; and demonstrates how CMPK2 deficiency alters mitochondrial structures and functions, thereby highlighting the mitochondria dysregulation as a critical pathogenic mechanism underlying brain calcification.
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Zhang C, Fu Q, Shao K, Liu L, Ma X, Zhang F, Zhang X, Meng L, Yan C, Zhao X. Indole-3-acetic acid improves the hepatic mitochondrial respiration defects by PGC1a up-regulation. Cell Signal 2022; 99:110442. [PMID: 35988807 DOI: 10.1016/j.cellsig.2022.110442] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 08/06/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022]
Abstract
Recent evidences have linked indole-3-acetic acid (I3A), a gut microbiota-derived metabolite from dietary tryptophan, with the protection against non-alcoholic fatty liver disease (NAFLD). However, the values of I3A on mitochondrial homeostasis in NAFLD have yet to be analyzed. In this study, we verified that I3A alleviated dietary-induced metabolic impairments, particularly glucose dysmetabolism and liver steatosis. Importantly, we expanded the understanding of I3A further to enhance mitochondrial oxidative phosphorylation in the liver by RNA-seq. Consistently, I3A restored the deficiency of mitochondrial respiration complex (MRC) capacity in palmitic acid (PA)-induced HepG2 without initiating oxidative stress in vitro. These changes were dependent on peroxisome proliferator-activated receptor γ coactivator 1 (PGC1)-a, a key regulator of mitochondrial biogenesis. Silencing of PGC1a by siRNA and pharmacologic inhibitor SR-18292, blocked the restoration of I3A on mitochondrial oxidative phosphorylation. In addition, pre-treatment of I3A guarded against the deficiency of MRC capacity. In conclusion, our findings uncovered that I3A increased hepatic PGC1a expression, contributing to mitochondrial respiration improvement in NAFLD.
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Affiliation(s)
- Chen Zhang
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Qingsong Fu
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Kai Shao
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Limin Liu
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Xiaotian Ma
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Fengyi Zhang
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Xiaodong Zhang
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Liying Meng
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - ChuanZhu Yan
- Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China
| | - Xiaoyun Zhao
- Department of Medical Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China; Qingdao Key Lab of Mitochondrial Medicine, Hefei Road No 758, Qingdao 266035, China.
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Wang GY, Lin PF, Yan CZ. [Research progress on the pathogenesis and intervention of statins-associated muscle symptoms]. Zhonghua Nei Ke Za Zhi 2022; 61:953-958. [PMID: 35922224 DOI: 10.3760/cma.j.cn112138-20210914-00642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- G Y Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - P F Lin
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - C Z Yan
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, China
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Lv XQ, Xu L, Lin PF, Yan CZ. Clinical, genetic, and pathological characterization of GNE myopathy in China. Neurol Sci 2022; 43:4483-4491. [PMID: 35138478 DOI: 10.1007/s10072-022-05938-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 02/04/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND GNE myopathy is the most common distal myopathy in China. We summarized the clinical, genetic, and pathological characteristics of 125 Chinese patients with GNE myopathy. METHODS We collected clinical data of 21 patients diagnosed at our hospital and 104 patients from previous reports. Clinical, genetic, and pathological characteristics were summarized. According to the location of mutations, patients were classified into groups to analyze genotype-phenotype correlation. We reviewed the pathological features and studied the expressions of neural cell adhesion molecule. RESULTS The severity of involvement of lower limb muscles was in the following order: tibialis anterior > biceps femoris > gastrocnemius > iliopsoas > quadriceps femoris. Mutation p.D207V was the most common variant in China. Patients carrying p.D207V tended to show later disease onset. In the epimerase/epimerase group, men had earlier disease onset than women (p < 0.05). In other groups, age at disease onset in females was earlier than that in males. Protein analysis showed decreased sialylation of NCAM and upregulation of LC3 in patients with different mutations. CONCLUSIONS Mutation p.D207V is the most common GNE variant in China. Involvement of flexor muscles in lower limbs was more obvious than extensor muscles. NCAM expression in patients with various mutations may be a useful diagnostic biomarker in GNE myopathy.
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Affiliation(s)
- Xiao-Qing Lv
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Ling Xu
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Peng-Fei Lin
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.
| | - Chuan-Zhu Yan
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
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Shao K, Yue YX, Zhao LM, Hao HJ, Ding XJ, Jiang P, Yan CZ, Li HF. Optimization of the cut-offs in acetylcholine receptor antibodies and diagnostic performance in myasthenia gravis patients. Clin Chim Acta 2022; 533:122-130. [PMID: 35750085 DOI: 10.1016/j.cca.2022.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aims to establish an optimization procedure to define the cut-offs of quantitative assays for acetylcholine receptor antibody (AChRAb), evaluate their diagnostic performance in myasthenia gravis (MG), and explore the association with clinical features. METHODS Samples from a representative cohort of 77 MG patients, 80 healthy controls (HC) and 80 other autoimmune diseases (OAD) patients were tested using competitive inhibition ELISA and RIA. Raw values (OD and cpm) and processed values (inhibition rate, binding rate and concentration) were used to define the cut-offs with statistical methods, a rough method, and receiver operating characteristic (ROC) curve. Optimal cut-offs were selected by comparing false positive rates in HC and OAD individuals. The diagnostic performance was evaluated in whole MG cohort and subgroups. Agreement between ELISA and RIA for AChRAb positivity were examined with Kappa test and McNemar test. Clinical association with AChRAb was explored by comparison among subgroups and with Spearman rank correlation. RESULTS The optimal cut-offs for AChRAb positivity were determined as OD≤1.79 for ELISA and cpm≥1234.12 for RIA, which derived from statistical method and performed better than those derived from ROC curves. The sensitivity and specificity were 74.03%, 100% for ELISA, and 74.03%, 99.37% for RIA. There was good agreement between ELISA and RIA for AChRAb positivity in whole cohort and subgroups (weighted к ≥0.71, p<0.01; McNemar test, p>0.05). Levels of AChRAb were different in MG subgroups (p<0.01). Correlation between Quantitative Myasthenia Gravis scores and AChRAb levels was moderate for ELISA and RIA (rs=-0.60 and 0.57, p<0.01). CONCLUSION The raw testing values of ELISA and RIA were found as optimal quantitative measures of AChRAb levels. There are good agreements on diagnostic performance between two assays. Quantitative values are more informative than positivity in association with clinical features.
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Affiliation(s)
- Kai Shao
- Department of Central Laboratory and Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
| | - Yao-Xian Yue
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Li-Ming Zhao
- Department of Nuclear Medicine, Linyi People's Hospital, Linyi, China.
| | - Hong-Jun Hao
- Laboratory of Neuroimmunology, Peking University First Hospital, Beijing, China.
| | - Xiao-Jun Ding
- Department of Neurology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
| | - Ping Jiang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Chuan-Zhu Yan
- Department of Central Laboratory and Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China; Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Hai-Feng Li
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Duan RN, Zhao DD, Liu YM, Yan CZ. A heterozygous deletion of PDGFB gene causes paroxysmal kinesigenic dyskinesia with primary familial brain calcification. Parkinsonism Relat Disord 2021; 92:83-87. [PMID: 34736156 DOI: 10.1016/j.parkreldis.2021.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/05/2021] [Accepted: 10/16/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Primary familial brain calcification (PFBC) is a neurodegenerative disease characterized with calcium deposition in multiple brain regions. Mutations in PDGFB have been discovered in sporadic and familial PFBC cases. While several known variants displayed loss-of function, no complete deletion of platelet-derived growth factor B (PDGFB) has been reported. METHODS For the diagnostic purpose, brain computerized tomography or magnetic resonance imaging scanning and whole-genome sequencing were performed on the proband and family members in the pedigree. RESULTS We identified a heterozygous PDGFB complete deletion in a Chinese pedigree. The proband presented with paroxysmal kinesigenic dyskinesia (PKD), a rare symptom in PFBC. The proband's mother carrying the same mutation was asymptomatic. CONCLUSIONS For the first time, we reported a PFBC with a heterozygous deletion of PDGFB, and provided evidence of haploinsufficiency in the pathogenesis of PFBC.
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Affiliation(s)
- Ruo-Nan Duan
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Dan-Dan Zhao
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Yi-Ming Liu
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Chuan-Zhu Yan
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Brain Science Research Institute, Qilu Hospital, Shandong University, Jinan, Shandong, 250012, China; Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Shandong University, Qingdao, Shandong, 266035, China.
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Duan RN, Yang CL, Du T, Liu A, Wang AR, Sun WJ, Li X, Li JX, Yan CZ, Liu QJ. Smek1 deficiency exacerbates experimental autoimmune encephalomyelitis by activating proinflammatory microglia and suppressing the IDO1-AhR pathway. J Neuroinflammation 2021; 18:145. [PMID: 34183017 PMCID: PMC8237434 DOI: 10.1186/s12974-021-02193-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/14/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Experimental autoimmune encephalomyelitis (EAE) is an animal disease model of multiple sclerosis (MS) that involves the immune system and central nervous system (CNS). However, it is unclear how genetic predispositions promote neuroinflammation in MS and EAE. Here, we investigated how partial loss-of-function of suppressor of MEK1 (SMEK1), a regulatory subunit of protein phosphatase 4, facilitates the onset of MS and EAE. METHODS C57BL/6 mice were immunized with myelin oligodendrocyte glycoprotein 35-55 (MOG35-55) to establish the EAE model. Clinical signs were recorded and pathogenesis was investigated after immunization. CNS tissues were analyzed by immunostaining, quantitative polymerase chain reaction (qPCR), western blot analysis, and enzyme-linked immunosorbent assay (ELISA). Single-cell analysis was carried out in the cortices and hippocampus. Splenic and lymph node cells were evaluated with flow cytometry, qPCR, and western blot analysis. RESULTS Here, we showed that partial Smek1 deficiency caused more severe symptoms in the EAE model than in controls by activating myeloid cells and that Smek1 was required for maintaining immunosuppressive function by modulating the indoleamine 2,3-dioxygenase (IDO1)-aryl hydrocarbon receptor (AhR) pathway. Single-cell sequencing and an in vitro study showed that Smek1-deficient microglia and macrophages were preactivated at steady state. After MOG35-55 immunization, microglia and macrophages underwent hyperactivation and produced increased IL-1β in Smek1-/+ mice at the peak stage. Moreover, dysfunction of the IDO1-AhR pathway resulted from the reduction of interferon γ (IFN-γ), enhanced antigen presentation ability, and inhibition of anti-inflammatory processes in Smek1-/+ EAE mice. CONCLUSIONS The present study suggests a protective role of Smek1 in autoimmune demyelination pathogenesis via immune suppression and inflammation regulation in both the immune system and the central nervous system. Our findings provide an instructive basis for the roles of Smek1 in EAE and broaden the understanding of the genetic factors involved in the pathogenesis of autoimmune demyelination.
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MESH Headings
- Animals
- Central Nervous System/immunology
- Central Nervous System/pathology
- Central Nervous System/physiopathology
- Cytokines
- Disease Models, Animal
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Encephalomyelitis, Autoimmune, Experimental/metabolism
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Gene Knockout Techniques
- Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism
- Inflammation/metabolism
- Interferon-gamma/metabolism
- Mice
- Mice, Inbred C57BL
- Microglia/immunology
- Microglia/metabolism
- Multiple Sclerosis/immunology
- Myelin-Oligodendrocyte Glycoprotein/immunology
- Myeloid Cells/immunology
- Myeloid Cells/metabolism
- Peptide Fragments/immunology
- Phosphoprotein Phosphatases/immunology
- Phosphoprotein Phosphatases/metabolism
- Receptors, Aryl Hydrocarbon/metabolism
- Signal Transduction
- Spleen/pathology
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Affiliation(s)
- Ruo-Nan Duan
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Chun-Lin Yang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Tong Du
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Ai Liu
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - An-Ran Wang
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wen-Jie Sun
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xi Li
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Jiang-Xia Li
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Qi-Ji Liu
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Cheeloo College of Medicine, School of Basic Medical Sciences, Shandong University, No.44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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11
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Su W, Li K, Li CM, Ma XX, Zhao H, Chen M, Li SH, Wang R, Lou BH, Chen HB, Yan CZ. Motor Symptom Lateralization Influences Cortico-Striatal Functional Connectivity in Parkinson's Disease. Front Neurol 2021; 12:619631. [PMID: 34054684 PMCID: PMC8160303 DOI: 10.3389/fneur.2021.619631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/08/2021] [Indexed: 12/05/2022] Open
Abstract
Objective: The striatum is unevenly impaired bilaterally in Parkinson's disease (PD). Because the striatum plays a key role in cortico-striatal circuits, we assume that lateralization affects cortico-striatal functional connectivity in PD. The present study sought to evaluate the effect of lateralization on various cortico-striatal circuits through resting-state functional magnetic resonance imaging (fMRI). Methods: Thirty left-onset Parkinson's disease (LPD) patients, 27 right-onset Parkinson's disease (RPD) patients, and 32 normal controls with satisfactory data were recruited. Their demographic, clinical, and neuropsychological information was collected. Resting-state fMRI was performed, and functional connectivity changes of seven subdivisions of the striatum were explored in the two PD groups. In addition, the associations between altered functional connectivity and various clinical and neuropsychological characteristics were analyzed by Pearson's or Spearman's correlation. Results: Directly comparing the LPD and RPD patients demonstrated that the LPD patients had lower FC between the left dorsal rostral putamen and the left orbitofrontal cortex than the RPD patients. In addition, the LPD patients showed aberrant functional connectivity involving several striatal subdivisions in the right hemisphere. The right dorsal caudate, ventral rostral putamen, and superior ventral striatum had decreased functional connectivity with the cerebellum and parietal and occipital lobes relative to the normal control group. The comparison between RPD patients and the controls did not obtain significant difference in functional connectivity. The functional connectivity between the left dorsal rostral putamen and the left orbitofrontal cortex was associated with contralateral motor symptom severity in PD patients. Conclusions: Our findings provide new insights into the distinct characteristics of cortico-striatal circuits in LPD and RPD patients. Lateralization of motor symptoms is associated with lateralized striatal functional connectivity.
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Affiliation(s)
- Wen Su
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Disease, Qilu Hospital of Shandong University, Jinan, China
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai Li
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chun-Mei Li
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Xin-Xin Ma
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Zhao
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Chen
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Shu-Hua Li
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Rui Wang
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Bao-Hui Lou
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Hai-Bo Chen
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chuan-Zhu Yan
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Disease, Qilu Hospital of Shandong University, Jinan, China
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12
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Li K, Su W, Chen M, Li CM, Ma XX, Wang R, Lou BH, Zhao H, Chen HB, Yan CZ. Abnormal Spontaneous Brain Activity in Left-Onset Parkinson Disease: A Resting-State Functional MRI Study. Front Neurol 2020; 11:727. [PMID: 32849201 PMCID: PMC7399038 DOI: 10.3389/fneur.2020.00727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/15/2020] [Indexed: 12/02/2022] Open
Abstract
Objective: Motor asymmetry is characteristic in Parkinson disease (PD). This phenomenon is originated from uneven degeneration of bilateral substantia nigra. However, this asymmetry may not restrict to substantia nigra or striatum. We aimed to determine the effect of asymmetry on spontaneous brain activity across the whole brain. Methods: We consecutively recruited 71 patients with PD, as well as 35 healthy controls, and collected relevant demographic, clinical, and neuropsychological information. The PD patients were divided into two groups according to the side of motor symptom onset. All the participants underwent resting-state functional magnetic resonance imaging, and spontaneous brain activity was assessed using amplitude of low-frequency fluctuation (ALFF). The associations between areas showing significant group differences and various clinical and neuropsychological measures were analyzed. Results: Finally, the data of 30 PD patients with left-onset (LPD), 27 PD patients with right-onset (RPD), and 32 healthy controls were obtained. The three groups had similar age and gender ratios. Our results demonstrated that LPD patients had increased ALFF in the left inferior temporal gyrus and decreased ALFF in bilateral thalamus and cerebellum anterior lobes than the control group. The value of ALFF of the left inferior temporal gyrus was correlated with motor function, and ALFF value of the thalamus was associated with cognition. Comparisons between LPD and RPD patients and between RPD patients and the controls did not yield significant difference. Conclusions: The present study provides new insights into the distinct characteristics of spontaneous brain activity in LPD, which may be associated with motor and cognitive function.
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Affiliation(s)
- Kai Li
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Wen Su
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Disease, Qilu Hospital of Shandong University, Jinan, China
| | - Min Chen
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Chun-Mei Li
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Xin-Xin Ma
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Rui Wang
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Bao-Hui Lou
- Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Hong Zhao
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Hai-Bo Chen
- Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Chuan-Zhu Yan
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Disease, Qilu Hospital of Shandong University, Jinan, China
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13
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Zhao YY, Duan RN, Ji L, Liu QJ, Yan CZ. Cervical Spinal Involvement in a Chinese Pedigree With Pontine Autosomal Dominant Microangiopathy and Leukoencephalopathy Caused by a 3' Untranslated Region Mutation of COL4A1 Gene. Stroke 2019; 50:2307-2313. [PMID: 31366314 DOI: 10.1161/strokeaha.119.024875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background and Purpose- Pontine autosomal dominant microangiopathy and leukoencephalopathy, a recently defined subtype of cerebral small vessel disease, is associated with mutations in COL4A1 (collagen type IV alpha 1 chain) 3' untranslated region. We here describe a pontine autosomal dominant microangiopathy and leukoencephalopathy pedigree with COL4A1 mutation presenting both pontine and cervical spinal cord involvement. Methods- For the diagnostic purpose, brain and spinal magnetic resonance imaging scanning, skin biopsy, and whole-exome sequencing were performed on the patients in the pedigree. Suspected pathogenic variants were further confirmed by cosegregation analysis using Sanger sequencing in the family members. Results- We identified a mutation located at the binding site of miR-29 (microRNA-29) in 3' untranslated region of COL4A1(c.*32G>A). The pontine autosomal dominant microangiopathy and leukoencephalopathy patients in this pedigree carried this variant, whereas other healthy family members but one did not. Magnetic resonance imaging showed lesions in the pons, white matter, and cervical spinal cord. Skin biopsy revealed thickened basal lamina in vessels. Conclusions- For the first time, we reported cervical spinal involvement in pontine autosomal dominant microangiopathy and leukoencephalopathy and expanded the clinical spectrum of this disease.
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Affiliation(s)
- Yu-Ying Zhao
- From the Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology (Y.-Y.Z., R.-N.D., C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China
| | - Ruo-Nan Duan
- From the Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology (Y.-Y.Z., R.-N.D., C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China.,Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Shandong University School of Basic Medical Sciences, Jinan, China (R.-N.D., Q.-J.L.)
| | - Lin Ji
- Department of Neurology, The Second Affiliated Hospital of Shandong University of TCM, Jinan, China (L.J.)
| | - Qi-Ji Liu
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Shandong University School of Basic Medical Sciences, Jinan, China (R.-N.D., Q.-J.L.)
| | - Chuan-Zhu Yan
- From the Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology (Y.-Y.Z., R.-N.D., C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China.,Brain Science Research Institute (C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China.,Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Shandong University, China (C.-Z.Y.)
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14
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Yu XL, Yan CZ, Ji KQ, Lin PF, Xu XB, Dai TJ, Li W, Zhao YY. Clinical, Neuroimaging, and Pathological Analyses of 13 Chinese Leigh Syndrome Patients with Mitochondrial DNA Mutations. Chin Med J (Engl) 2019; 131:2705-2712. [PMID: 30425197 PMCID: PMC6247594 DOI: 10.4103/0366-6999.245265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Leigh syndrome (LS) is a rare disease caused by mitochondrial defects and has high phenotypic and genotypic heterogeneity. We analyzed the clinical symptoms, neuroimaging, muscular histopathology, and genotypes of 13 Chinese LS patients with mitochondrial DNA (mtDNA) mutations. Methods Mutations in mtDNA were identified by targeted sequencing. The brain imaging features on magnetic resonance imaging (MRI) were analyzed. The levels of lactate in fasting blood and cerebrospinal fluid (CSF) were routinely tested. The levels of urinary organic acids, plasma amino acids, and acylcarnitines were examined with gas chromatography-mass spectrometry and tandem mass spectrometry. The histopathological traits of skeletal muscles were analyzed under microscope. Results Among 13 patients, mutations of MT-NDs (n = 8) and MT-ATP6 (n = 4) genes were most common. Strabismus (8/13), muscle weakness (8/13), and ataxia (5/13) were also common, especially for the patients with late-onset age after 2 years old. However, respiratory distress was common in patients with early-onset age before 2 years old. The most frequently affected brain area in these patients was the brain stem (12/13), particularly the dorsal part of midbrain, followed by basal ganglia (6/13), thalamus (6/13), cerebellum (5/13), and supratentorial white matter (2/13). Besides, the elevated lactate levels in CSF (6/6) were more common than those in serum (7/13). However, the analysis of abnormal plasma amino acid and urinary organic acid showed limited results (0/3 and 1/4, respectively). Muscular histopathology showed mitochondrial myopathy in the three late-onset patients but not in the early-onset ones. Conclusions Noninvasive genetic screening is recommended for mtDNA mutations in MT-NDs and MT-ATP6 genes in patients with ophthalmoplegia, muscle weakness, ataxia, and respiratory disorder. Furthermore, the lactate detection in CSF and the brain MRI scanning are suggested as the diagnosis methods for LS patients with mtDNA mutations.
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Affiliation(s)
- Xiao-Lin Yu
- Department of Geriatrics Medicine; Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases; Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Chuan-Zhu Yan
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Jinan, Shandong 250012; Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Shandong University, Qingdao, Shandong 266035; Brain Science Research Institute, Shandong University, Jinan, Shandong 250012, China
| | - Kun-Qian Ji
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Peng-Fei Lin
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Xue-Bi Xu
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Ting-Jun Dai
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Wei Li
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Yu-Ying Zhao
- Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
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Affiliation(s)
- Sheng-Jun Wang
- Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, China
| | - Yu-Ying Zhao
- Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, China
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, China.
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16
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Wang SJ, Yan CZ, Wen B, Zhao YY. Clinical feature and outcome of late-onset cobalamin C disease patients with neuropsychiatric presentations: a Chinese case series. Neuropsychiatr Dis Treat 2019; 15:549-555. [PMID: 30863077 PMCID: PMC6391119 DOI: 10.2147/ndt.s196924] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The Cobalamin C (cblC) disease is an inborn error of cobalamin metabolism. Late-onset cblC disease was diagnosed in patients having overt symptoms after 4 years of age. The late-onset cblC disease patients were rare and easily misdiagnosed. This study analyzed the clinical presentations, gene mutations, and treatments of Chinese patients with late-onset cblC disease. METHODS The clinical data of 26 Han Chinese patients diagnosed with late-onset cblC disease were retrospectively analyzed. All patients underwent serum homocysteine level exam, urine concentrations of organic acids measurement, neuroimaging scans, gene analysis, and treatments evaluations. RESULTS The mean age at disease onset and diagnosis was 17.8±7.0 years. The most frequent neuropsychiatric disturbances were lower limb weakness (50%), psychiatric disturbances (46.2%), and gait instability (42.3%). The mean methylmalonic acid level in urine was 107.4±56.6 μmol/L, and mean serum total homocysteine was 105.4±41.0 μmol/L. The most common abnormal radioimaging changes were observed in the spinal cord (88%) and brain (32%). Scoliosis was detected in 85.7% of patients. The methylmalonic aciduria and homocystinuria type C protein gene analysis showed that c.482G>A (57.7%) and c.609G>A (34.6%) mutations were the most frequent genotypes. After treatments with hydroxycobalamin, betaine, folic acid, L-carnitine, and compound vitamin B, the clinical features and biochemical parameters of patients with late-onset cblC disease were found to be alleviated. CONCLUSION In our late-onset cblC disease cases, lower limb weakness, psychiatric disturbances, and gait instability were the most frequent manifestations. Patients responded well to the drug treatments with hydrocobalamin and betaine. When juvenile or adult patients with hyperhomocysteinemia present with neurological symptoms, cblC disease needs to be considered.
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Affiliation(s)
- Sheng-Jun Wang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,
| | - Bing Wen
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,
| | - Yu-Ying Zhao
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,
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Wang SJ, Yan CZ, Liu YM, Zhao YY. Late-onset cobalamin C deficiency Chinese sibling patients with neuropsychiatric presentations. Metab Brain Dis 2018; 33:829-835. [PMID: 29374341 DOI: 10.1007/s11011-018-0189-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/17/2018] [Indexed: 01/06/2023]
Abstract
The Cobalamin C deficiency (cblC), characterized with elevated methylmalonic acidemia and homocystinuria in plasma, is an inborn error of cobalamin metabolism. The late-onset cblC siblings patients were rarely reported. In this study, we analyzed the clinical presentations and treatment outcomes of late-onset cblC in Chinese sibling patients with neuropsychiatric presentations. The clinical data of four pairs of Chinese patients were retrospectively analyzed. Serum homocysteine, urine organic acids measurements, neuroimaging exams and gene analysis were carried out in all patents. Patients were reevaluated after treatments with cobalamin, folate, betaine, L-carnitine and compound vitamin B. The mean age at disease onset was 13.7 (range 2-19) years. The neuropsychiatric disturbances including cognitive decline (3/8), psychiatric disturbances (4/8), gait instability (2/8), lower extremity weakness and numbness (3/8) and thromboembolic events (1/8). Two patients suffered nephropathy. The mean serum homocysteine when patients were diagnosed was 109.4 (range 69.5-138) μM/L. The abnormal radioimaging included scoliosis by X-ray (5/6), cerebral atrophy (4/6) and spinal cord atrophy (3/6) by MRI scan. Three pairs of siblings showed heterozygous mutations of MMACHC gene including c.482G > A (4/6), c.354G > C (2/6), c.570insT (2/6), c.445_446del (2/6) and c.656_4658del (2/6). The other two siblings showed homozygous mutation with c.452A > G in MMACHC gene. After treatments, the psychiatric symptoms were obviously relieved in all the patients. In Chinese siblings with late-onset cblC, the main clinic manifestation and abnormal radioimaging were cognitive decline and cerebral atrophy respectively. The most common gene mutation was c.482G > A of MMACHC gene. The patients responded well to the treatments.
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Affiliation(s)
- Sheng-Jun Wang
- Department of Neurology, Qilu Hospital, Shandong University, 107#,Wen Hua Xi Road, Ji'nan, 250012, People's Republic of China
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital, Shandong University, 107#,Wen Hua Xi Road, Ji'nan, 250012, People's Republic of China
| | - Yi-Ming Liu
- Department of Neurology, Qilu Hospital, Shandong University, 107#,Wen Hua Xi Road, Ji'nan, 250012, People's Republic of China
| | - Yu-Ying Zhao
- Department of Neurology, Qilu Hospital, Shandong University, 107#,Wen Hua Xi Road, Ji'nan, 250012, People's Republic of China.
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Liu T, Hou Y, Dai TJ, Yan CZ. Upregulation of Interleukin 21 and Interleukin 21 Receptor in Patients with Dermatomyositis and Polymyositis. Chin Med J (Engl) 2018; 130:2101-2106. [PMID: 28836555 PMCID: PMC5586180 DOI: 10.4103/0366-6999.213419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: The immunopathologic mechanism underlying dermatomyositis (DM) and polymyositis (PM) remains poorly understood. Many cytokines play a pathogenic role in DM and PM. Interleukin 21 (IL-21) has a pleiotropic effect on inflammation regulation. This study aimed to detect the serum IL-21 level and investigate the expression of IL-21 and IL-21 receptor (IL-21R) in muscle tissues of patients with DM and PM. Methods: Biopsied muscle samples were obtained from 11 patients with DM, 12 with PM, and six controls; mRNA levels of IL-21 and IL-21R were analyzed by real-time quantitative reverse transcription-polymerase chain reaction; and immunohistochemical staining was used to evaluate the protein expression of IL-21 and IL-21R. Serum samples were obtained from 36 patients with DM, 19 with PM, and 20 healthy controls. The serum IL-21 level was detected by enzyme-linked immunosorbent assay. Results: The expression of IL-21 was upregulated in patients with DM and PM. The IL-21 mRNA level was significantly increased in muscle tissues of patients with DM and PM (DM vs. control, P = 0.001; PM vs. control, P = 0.001), whereas IL-21R mRNA level in patients with DM/PM was not statistically different from that of healthy controls. Immunohistochemical staining showed both IL-21 and IL-21R were significantly expressed in the inflammatory cells in muscle tissues of patients with DM and PM. The serum IL-21 level was also significantly higher in patients with DM/PM than in controls (DM vs. control, 49.12 [45.28, 60.07] pg/ml vs. 42.54 [38.69, 48.85] pg/ml, P = 0.001; PM vs. control, 50.77 [44.19, 60.62] pg/ml vs. 42.54 [38.69, 48.85] pg/ml, P = 0.005). Conclusions: IL-21 expression is upregulated in patients with DM and PM in both muscle tissue and serum. In addition, IL-21R protein is highly expressed in affected muscle tissues of patients with DM and PM. IL-21 may play a pathogenic role through IL-21R in patients with DM and PM.
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Affiliation(s)
- Tao Liu
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong 250012; Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Ying Hou
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Ting-Jun Dai
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Chuan-Zhu Yan
- Research Institute of Neuromuscular and Neurodegenerative Diseases, Department of Neurology, Qilu Hospital, Shandong University; Brain Science Research Institute, Shandong University, Jinan, Shandong 250012, China
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Li TS, Shi H, Wang L, Yan CZ. Effect of Bone Marrow Mesenchymal Stem Cells on Satellite Cell Proliferation and Apoptosis in Immobilization-Induced Muscle Atrophy in Rats. Med Sci Monit 2016; 22:4651-4660. [PMID: 27898654 PMCID: PMC5132424 DOI: 10.12659/msm.898137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 04/11/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Muscle atrophy due to disuse occurs along with adverse physiological and functional changes, but bone marrow stromal cells (MSCs) may be able to act as muscle satellite cells to restore myofibers. Thus, we investigated whether MSCs could enhance the proliferation of satellite cells and suppress myonuclear apoptosis during immobilization. MATERIAL AND METHODS We isolated, purified, amplified, and identified MSCs. Rats (n=48) were randomized into 3 groups: WB group (n=16), IM-PBS group (n=16), and IM-MSC (n=16). Rat hind limbs were immobilized for 14 d, treated with MSCs or phosphate-buffered saline (PBS), and then studied using immunohistochemistry and Western blot analysis to characterize the proteins involved. Apoptosis was assessed by terminal deoxynucleotidyl transferase (TdT)-mediated deoxy-UTP nick end labeling (TUNEL) method. RESULTS We compared muscle mass, cross-sectional areas, and peak tetanic forces and noted insignificant differences between PBS- and MSC-treated animals, but satellite cell proliferation was significantly greater after MSC treatment (p<0.05). Apoptotic myonuclei were reduced (p<0.05) after MSC treatment as well. Pro-apoptotic Bax was down-regulated and anti-apoptotic Bcl-2 and p-Akt protein were upregulated (p<0.05). CONCLUSIONS MSCs injected during hind limb immobilization can maintain satellite cell activity by suppressing myonuclear apoptosis.
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Affiliation(s)
- Tie-Shan Li
- Department of Neurology and Neuromuscular Center, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China
- Department of Rehabilitation, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Hao Shi
- Shandong Rehabilitation Research Center, Jinan, Shandong, P.R. China
| | - Lin Wang
- Department of Rehabilitation, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Chuan-Zhu Yan
- Department of Neurology and Neuromuscular Center, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China
- Brain Science Research Institute, Shandong University, Jinan, Shandong, P.R. China
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Wang SJ, Zhao YY, Wang QZ, Guo B, Liu YM, Yan CZ. Pearls & Oy-sters: Limbic encephalitis associated with positive anti-LGI1 and antithyroid antibodies. Neurology 2016; 86:e16-8. [PMID: 26755620 DOI: 10.1212/wnl.0000000000002259] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sheng-Jun Wang
- From the Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, P.R. China
| | - Yu-Ying Zhao
- From the Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, P.R. China
| | - Qin-Zhou Wang
- From the Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, P.R. China
| | - Bin Guo
- From the Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, P.R. China
| | - Yi-Ming Liu
- From the Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, P.R. China.
| | - Chuan-Zhu Yan
- From the Department of Neurology, Qilu Hospital, Shandong University, Ji'nan, P.R. China.
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Yu XL, Jia RZ, Shan PY, Yan CZ, Liu AF. Myotonic Dystrophy Type 1 with Syringomyelia in a Young Patient. Chin Med J (Engl) 2016; 129:487-9. [PMID: 26879026 PMCID: PMC4800853 DOI: 10.4103/0366-6999.176070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | | | | | - Ai-Fen Liu
- Department of Geriatrics, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
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Xu JW, Liu FC, Li W, Zhao YY, Zhao DD, Luo YB, Lu JQ, Yan CZ. Cylindrical Spirals in Skeletal Muscles Originate From the Longitudinal Sarcoplasmic Reticulum. J Neuropathol Exp Neurol 2016; 75:148-55. [DOI: 10.1093/jnen/nlv013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Diao ZY, Wang CL, Qi HS, Jia GY, Yan CZ. Significance of decreased serum interleukin-10 levels in the progression of cerebral infarction. Clin Exp Med 2015; 16:203-11. [PMID: 25847570 DOI: 10.1007/s10238-015-0346-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/21/2015] [Indexed: 01/05/2023]
Abstract
Anti-inflammatory cytokine and its serological detection may have an important role in the process of cardiovascular and cerebrovascular diseases. We investigated whether serum interleukin-10 (IL-10) is associated with cerebral infarction or not in the general population. Identified comprehensive searching was performed covering PubMed, EMBASE, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine, and China National Knowledge Infrastructure databases. Two reviewers extracted data and assessed studies independently. Information was extracted separately and classed into Asians and Caucasians. Summary standardized mean differences (SMDs) with 95 % confidence intervals (CI) were used with the utilization of Z test. Nine studies ranged from 2003 to 2014 were collected for meta-analysis. Results identified a negative association between serum IL-10 levels and cerebral infarction (SMD = 1.80, 95 % CI 0.79-2.81, P < 0.001). Country-subgroup analysis showed that low IL-10 level may be the main risk factor for cerebral infarction in India (SMD = 1.44, 95 % CI 1.13-1.75, P < 0.001) and Croatia (SMD = 2.96, 95 % CI 2.48-3.44, P < 0.001). In the ethnicity-stratified subgroup analysis, serum IL-10 levels were negatively correlated with cerebral infarction in Asians (SMD = 2.52, 95 % CI 0.47-4.57, P = 0.016), while not in Caucasians (P > 0.05). The lower serum IL-10 concentration was significantly associated with an increased likelihood of cerebral infarction in this meta-analysis. More prospective studies should be conducted to provide stronger evidence justifying the use of IL-10 as new biomarker to identify a predisposition toward cerebral infarction.
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Affiliation(s)
- Zeng-Yan Diao
- Department of Neurology, Qilu Hospital, Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong, People's Republic of China
| | - Cui-Lan Wang
- Department of Neurology, Qilu Hospital, Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong, People's Republic of China
| | - Hong-Shun Qi
- Department of Neurology, Traffic Hospital, Shandong Province, Jinan, 250012, Shandong, People's Republic of China
| | - Guo-Yong Jia
- Department of Neurology, Qilu Hospital, Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong, People's Republic of China
| | - Chuan-Zhu Yan
- Department of Neurology, Qilu Hospital, Shandong University, No. 107, Wenhua West Road, Jinan, 250012, Shandong, People's Republic of China.
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Gong FT, Yu LP, Gong YH, Zhang YX, Wang ZG, Yan CZ. Blood pressure control in ultra-early basal ganglia intracerebral hemorrhage. Eur Rev Med Pharmacol Sci 2015; 19:412-415. [PMID: 25720712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE We performed this study to investigate the effect of blood pressure control in ultra-early basal ganglia intracerebral hemorrhage. PATIENTS AND METHODS 120 patients with ultra-early basal ganglia intracerebral hemorrhage were randomly divided into experimental group (strengthened antihypertensive) and control (normal antihypertensive). Each group consists of 60 patients, whose contractive pressure were controlled by intravenous antihypertensive drugs among 130-140 mmHg and 160-180 mmHg respectively for 24 h, after 1 h of beginning treatment. They were all evaluated by NIH Stroke Scale (NIHSS) before and after the treatment. Cranial CT, hematoma volume, hematoma enlargement, edema volume, serum matrix metalloproteinase-9 level were performed and compared between groups. RESULTS After 24 h, hematoma volume and hematoma enlargement in the experimental group was significantly lower than control (p < 0.05). After 14 days, NIHSS score in the experimental group was significantly lower than control (p < 0.05). Cerebral edema amount and serum MMP-9 level in the experimental group were significantly lower than control after 5 days and 14 days. CONCLUSIONS Ultra-early basal ganglia intracerebral hemorrhage can remarkably reduce hematoma enlargement, cerebral edema, serum MMP-9 level, and improve the neurological function.
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Affiliation(s)
- F T Gong
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China.
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Song JH, Yu JT, Liu M, Yan CZ, Tan L. Genetic association between ADAM10 gene polymorphism and Alzheimer's disease in a Northern Han Chinese population. Brain Res 2011; 1421:78-81. [DOI: 10.1016/j.brainres.2011.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Revised: 09/06/2011] [Accepted: 09/06/2011] [Indexed: 10/17/2022]
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Yan CZ. [The past and future of mitochondria medicine]. Zhonghua Nei Ke Za Zhi 2009; 48:265-266. [PMID: 19576108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ren SC, Yan CZ, Li MX, Liu SP, Wu JL, Zhao YY, Li W, Li DN. [Dysferlin expression in limb-girdle muscular dystrophy and Miyoshi myopathy: analysis of 45 cases]. Zhonghua Yi Xue Za Zhi 2007; 87:1486-90. [PMID: 17785089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To clarify the expression patterns of dysferlin in limb-girdle muscular dystrophy (LGMD) and Miyoshi myopathy (MM), and to investigate the frequency and clinicopathologic features of dysferlinopathy. METHODS The expressing patterns of dysferlin were analyzed by immunohistochemistry, with a set of antibodies against dystrophin, alpha-sarcoglycan and dysferlin, in the biopsied muscle specimens from 45 patients with LGMD or MM diagnosed on the basis of clinical manifestations and muscle pathological features. The specimens with abnormal dysferlin expression shown by IHC were further analyzed with Western blotting for a quantitative evaluation. RESULTS Eight patients were proved to be primary dysferlinopathy according to total dysferlin deficiency or a significant decrease of dysferlin (less than 15% that of normal value). The clinical manifestations of 5 of the 8 dysferlinopathy patients were consistent with those of typical MM, and the other 3 were diagnosed as with LGMD. All patients had an average onset at the age of 18.8 years. Two of them had family history, and one patient had consanguineous mating parents, meaning an autosomal recessive inheritance pattern. The serum CK levels were 6240 IU/L on average. EMG showed myogenic patterns in all patients. Muscular pathology showed typical changes of muscular dystrophy in all patients. Focal or scattered inflammatory cellular infiltrations were found in 3 cases. CONCLUSION The clinical and pathological features of dysferlinopathy are nonspecific. Inflammatory cellular infiltrations are relatively common in biopsied muscles of dysferlinopathy patients, which may cause misdiagnosis of inflammatory myopathy. Identification of dysferlin expression by IHC and Western blotting are essential for the diagnosis of dysferlinopathy and differential diagnosis of inflammatory myopathy.
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Affiliation(s)
- Shou-Chen Ren
- Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, China
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